JP4767761B2 - High frequency treatment tool - Google Patents

High frequency treatment tool Download PDF

Info

Publication number
JP4767761B2
JP4767761B2 JP2006156392A JP2006156392A JP4767761B2 JP 4767761 B2 JP4767761 B2 JP 4767761B2 JP 2006156392 A JP2006156392 A JP 2006156392A JP 2006156392 A JP2006156392 A JP 2006156392A JP 4767761 B2 JP4767761 B2 JP 4767761B2
Authority
JP
Japan
Prior art keywords
sheath
bent portion
pair
arm portions
frequency treatment
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
JP2006156392A
Other languages
Japanese (ja)
Other versions
JP2007319612A (en
Inventor
雄太 六鎗
努 中村
千賀 宮島
勉 岡田
直久 矢作
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Medical Systems Corp
Original Assignee
Olympus Medical Systems Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Medical Systems Corp filed Critical Olympus Medical Systems Corp
Priority to JP2006156392A priority Critical patent/JP4767761B2/en
Priority to EP14164119.1A priority patent/EP2756816B1/en
Priority to EP07011059.8A priority patent/EP1864622B1/en
Priority to US11/810,372 priority patent/US9033978B2/en
Publication of JP2007319612A publication Critical patent/JP2007319612A/en
Application granted granted Critical
Publication of JP4767761B2 publication Critical patent/JP4767761B2/en
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/32056—Surgical snare instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00898—Alarms or notifications created in response to an abnormal condition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A61B2018/141—Snare
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/144—Wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B2018/1475—Electrodes retractable in or deployable from a housing

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)

Description

本発明は、高周波処置具に関する。   The present invention relates to a high-frequency treatment instrument.

内視鏡を利用して粘膜等の生体組織を切除する処置として、消化管の表面にできた病変部を切除するために、病変部の外側の正常粘膜を全周切開した後に粘膜下層を剥離し、病変部を切除する等の内視鏡的粘膜下層剥離術（Endoscopic Submucosal Dissection：ＥＳＤ）が知られている。   As a treatment to remove living tissue such as mucous membrane using an endoscope, in order to remove the lesion on the surface of the digestive tract, the normal mucous membrane outside the lesion is completely incised and then the submucosal layer is peeled off Endoscopic submucosal dissection (ESD) such as excision of a lesion is known.

この種の切除処置に用いられる処置具としては、様々なものが提供されているが、例えば、その１つとしてシースに収納された棒状電極部の先端に処置電極であるナイフ部を備えた高周波処置具が知られている（例えば、特許文献１参照）。
この特許文献１に記載されている高周波処置具によれば、ナイフ部に高周波電流を流すことにより、ナイフ部に接触した粘膜を切開して粘膜下層を剥離することができる。
特開平８−２９９３５５号公報 Various treatment tools used for this type of excision treatment are provided. For example, as one of them, a high-frequency device provided with a knife portion as a treatment electrode at the tip of a rod-like electrode portion housed in a sheath. A treatment tool is known (see, for example, Patent Document 1).
According to the high-frequency treatment instrument described in Patent Document 1, by applying a high-frequency current to the knife part, the mucosa in contact with the knife part can be incised to peel the submucosa.
JP-A-8-299355

しかしながら、上記従来の高周波処置具は、ナイフ部がその進退方向に延びて設けられているので、ナイフ部を対象組織に当てて切開する際には、対象組織との間で接触面積を確保する必要がある。そのため、剥離の際に処置電極の進退操作だけでなく、内視鏡の湾曲操作・進退操作も必要となる。この場合、内視鏡による観察と操作とを同時に行わなければならず、各操作において細心の注意が必要となり、高度な操作技術を要する。
本発明は上記事情に鑑みて成されたものであり、内視鏡の湾曲操作に拠らなくても対象組織に対する処置を可能として、手技の容易化を図ることができる高周波処置具を提供することを目的とする。 However, since the conventional high-frequency treatment instrument is provided with the knife portion extending in the advance and retreat direction, when the knife portion is applied to the target tissue for incision, a contact area with the target tissue is ensured. There is a need. Therefore, not only the treatment electrode advance / retreat operation but also the bending / advance operation of the endoscope are required at the time of peeling. In this case, observation and operation with an endoscope must be performed at the same time, and careful attention is required for each operation, and advanced operation techniques are required.
The present invention has been made in view of the above circumstances, and provides a high-frequency treatment instrument capable of performing a procedure on a target tissue without facilitating the bending operation of an endoscope and facilitating a procedure. For the purpose.

本発明は、上記課題を解決するため、以下の手段を採用する。
本発明に係る高周波処置具は、シースと、該シース内に進退自在に配され、前記シースに沿って配された第一線状部、該第一線状部の先端に形成された第一折り曲げ部、該第一折り曲げ部から延びる第二線状部、及び、該第二線状部の途中に形成された第二折り曲げ部、を有する細長延長部材とを備え、前記第一線状部及び前記第二線状部を前記シースの先端方向に前進させて、前記第一折り曲げ部及び前記第二折り曲げ部を前記シースから突出させたときに、前記第一折り曲げ部と前記第二折り曲げ部との間に、前記シースの中心軸線に対して交差する処置電極が形成され、前記第一折り曲げ部を前記シース内に位置させつつ前記第二折り曲げ部を前記シースから突出させたときに、前記シースから突出した前記細長延長部材全体が、前記シースと平行に延びる処置電極となり、前記第一線状部及び前記第二線状部のシース先端からの突出量を規制する規制部が、前記第二折り曲げ部よりも基端側の前記第一線状部及び前記第二線状部に設けられていることを特徴とする。 The present invention employs the following means in order to solve the above problems.
A high-frequency treatment device according to the present invention is a sheath, a first linear portion that is disposed in the sheath so as to be able to advance and retreat, and is formed at the tip of the first linear portion. An elongated extension member having a bent portion, a second linear portion extending from the first bent portion, and a second bent portion formed in the middle of the second linear portion, and the first linear portion And when the second linear portion is advanced in the distal direction of the sheath and the first bent portion and the second bent portion are protruded from the sheath, the first bent portion and the second bent portion A treatment electrode that intersects the central axis of the sheath is formed, and when the second bent portion protrudes from the sheath while the first bent portion is positioned in the sheath, The entire elongated extension member protruding from the sheath is It becomes treatment electrode extending in parallel to the over scan, regulating portion for regulating the amount of projection of the sheath distal end of the first linear portion and the second linear portion, the said second fold base end side than the The first linear portion and the second linear portion are provided.

この発明は、細長延長部材の第一線状部をシースの先端から突出させる方向に移動したときに、第一折り曲げ部を開閉中心として、第一線状部に対して第二線状部の基端側を拡開させることができ、第二線状部とシースの中心軸線とを交差させることができる。   In the present invention, when the first linear portion of the elongated extending member is moved in a direction in which the first linear portion protrudes from the distal end of the sheath, the second linear portion is positioned relative to the first linear portion with the first bent portion as an opening / closing center. The proximal end side can be expanded, and the second linear portion and the central axis of the sheath can be crossed.

また、処置電極がシースの中心軸線と交差する位置に配されるので、処置電極と
対象組織との間の接触面積を従来の接触面積よりも増加させることができる。 Further, since the treatment electrode is arranged at a position intersecting the central axis of the sheath, the contact area between the treatment electrode and the target tissue can be increased as compared with the conventional contact area.

さらに、規制部によって、第一線状部及び第二線状部のシースからの突出量を調整
することができる。
 Furthermore, the amount of protrusion of the first linear portion and the second linear portion from the sheath can be adjusted by the restricting portion.

本発明によれば、内視鏡の湾曲操作に拠らなくても対象組織に対する処置を可能として、手技の容易化を図ることができる。   According to the present invention, it is possible to perform a treatment on a target tissue without relying on a bending operation of an endoscope, thereby facilitating a procedure.

本発明に係る第１の実施形態について、図１から図８を参照して説明する。
本実施形態に係る高周波処置具１は、図示しない病変部（対象組織）に対して高周波処置を行う高周波処置具であって、図１から図４に示すように、可撓性を有する細長のシース２と、シース２内を進退自在に配されて、シース２内では閉じた状態とされ、かつ、シース２の先端から突出したときには、シース２の中心軸線Ｃから離間する方向に開く一対の腕部３Ａ，３Ｂと、一対の腕部３Ａ，３Ｂの互いの先端側を連結して、一対の腕部３Ａ，３Ｂが開いたときに腕部３Ａ，３Ｂ間に張られる線状の処置電極５と、シース２内に進退自在に延びて配され、先端に処置電極５と接続された操作ワイヤ（細長延長部材）６と、シース２及び操作ワイヤ６の基端が接続されて、シース２に対して操作ワイヤ６を進退操作させる操作部７とを備えている。 A first embodiment according to the present invention will be described with reference to FIGS.
A high-frequency treatment instrument 1 according to the present embodiment is a high-frequency treatment instrument that performs high-frequency treatment on a lesion (target tissue) (not shown), and has a flexible and long shape as shown in FIGS. 1 to 4. A pair of sheaths 2, which are arranged so as to be able to advance and retract in the sheath 2, are closed in the sheath 2, and open in a direction away from the central axis C of the sheath 2 when protruding from the distal end of the sheath 2. A linear treatment electrode stretched between the arm portions 3A and 3B when the arm portions 3A and 3B are connected to the distal ends of the pair of arm portions 3A and 3B and the pair of arm portions 3A and 3B are opened. 5 and an operation wire (elongated extension member) 6 that is arranged to extend and retract in the sheath 2 and is connected to the treatment electrode 5 at the distal end, and the sheath 2 and the proximal end of the operation wire 6 are connected to each other, and the sheath 2 And an operation portion 7 for moving the operation wire 6 forward and backward. That.

シース２は、図示しない内視鏡の処置具チャンネルに挿通可能な外径となっている。
一対の腕部３Ａ，３Ｂは、ともに管状に形成されており、何れもシース２と連通されている。一対の腕部３Ａ，３Ｂの少なくともシース２先端近傍は、シース２に対して湾曲可能な可撓性を有している。一対の腕部３Ａ，３Ｂの先端側であって、一対の腕部３Ａ，３Ｂを閉じた際に互いに対向する位置には、処置電極５が挿通可能な挿通孔８Ａ，８Ｂが設けられている。一対の腕部３Ａ，３Ｂの先端は、封止部材１０によって封止されている。一方の腕部３Ａの基端側は、操作ワイヤ６の先端近傍まで延びて形成されている。 The sheath 2 has an outer diameter that can be inserted into a treatment instrument channel of an endoscope (not shown).
The pair of arm portions 3 </ b> A and 3 </ b> B are both formed in a tubular shape, and both communicate with the sheath 2. At least the vicinity of the distal end of the sheath 2 of the pair of arm portions 3 </ b> A and 3 </ b> B has flexibility capable of bending with respect to the sheath 2. Insertion holes 8A and 8B through which the treatment electrode 5 can be inserted are provided at the distal end sides of the pair of arm portions 3A and 3B and facing each other when the pair of arm portions 3A and 3B are closed. . The ends of the pair of arm portions 3A and 3B are sealed with a sealing member 10. The base end side of one arm portion 3 </ b> A is formed to extend to the vicinity of the distal end of the operation wire 6.

処置電極５は、ワイヤ状に形成されており、一方の腕部３Ａを進退可能に挿通されて挿通孔８Ａから突出し、他方の腕部３Ｂの挿通孔８Ｂから該腕部３Ｂ内を挿通されて、一対の腕部３Ａ，３Ｂとシース２とが接続される位置に、処置電極５の先端が折り返された状態で固定されている。そのため、処置電極５は、一方の腕部３Ａ内では進退自在とされ、他方の腕部３Ｂ内では相対的に固定された状態となっている。   The treatment electrode 5 is formed in a wire shape, is inserted through the arm 3A so as to be able to advance and retreat, protrudes from the insertion hole 8A, and is inserted through the arm 3B from the insertion hole 8B of the other arm 3B. The distal end of the treatment electrode 5 is fixed at a position where the pair of arm portions 3A, 3B and the sheath 2 are connected. For this reason, the treatment electrode 5 is allowed to advance and retreat within the one arm 3A, and is relatively fixed within the other arm 3B.

一対の腕部３Ａ，３Ｂを所定の開き角度で拡開させたときに一方の腕部３Ａの挿通孔８Ａに位置される処置電極５には、挿通孔８Ａに係止して処置電極５の進退移動が規制される折曲部１１が形成されている。   When the pair of arm portions 3A and 3B are expanded at a predetermined opening angle, the treatment electrode 5 positioned in the insertion hole 8A of one arm portion 3A is engaged with the insertion hole 8A and the treatment electrode 5 A bent portion 11 is formed in which forward / backward movement is restricted.

操作部７は、シース２の基端に接続された操作部本体１３と、操作ワイヤ６の基端が接続されて操作部本体１３に対してスライド自在なスライダ１５とを備えている。スライダ１５には、操作ワイヤ６と電気的に接続されて、図示しない高周波電源から延びる接続ケーブルが接続される電極端子１６が配されている。   The operation unit 7 includes an operation unit main body 13 connected to the proximal end of the sheath 2 and a slider 15 connected to the proximal end of the operation wire 6 and slidable with respect to the operation unit main body 13. The slider 15 is provided with an electrode terminal 16 electrically connected to the operation wire 6 and connected to a connection cable extending from a high frequency power source (not shown).

次に、本実施形態に係る高周波処置具１により、粘膜下層Ｗを剥離することで消化管の表面にできた病変部Ｘを切除する手技を例として、高周波処置具１の作用について説明する。   Next, the operation of the high-frequency treatment tool 1 will be described by taking as an example a procedure for removing the lesion X formed on the surface of the digestive tract by peeling off the submucosal layer W with the high-frequency treatment tool 1 according to this embodiment.

まず、図５に示すように、図示しない内視鏡の処置具チャンネルを介して注射針１７を体腔内に導入し、切除する病変部Ｘ近傍の粘膜下層Ｗに生理食塩水を局注して、図６に示すように、病変部Ｘを膨隆させる。なお、この局注を行う前に、病変部Ｘ周辺に色素散布を行い、病変部Ｘの境界を明確にしたうえで、従来の高周波ナイフ１８を用いて、病変部Ｘ周囲を囲む複数の位置で粘膜Ｓにマーキングを施すことが望ましい。   First, as shown in FIG. 5, an injection needle 17 is introduced into a body cavity via a treatment instrument channel of an endoscope (not shown), and physiological saline is locally injected into the submucosa W near the lesion X to be excised. As shown in FIG. 6, the lesioned part X is bulged. Prior to this local injection, pigment is sprayed around the lesion X to clarify the boundary of the lesion X, and a plurality of positions surrounding the lesion X using the conventional high-frequency knife 18 It is desirable to mark the mucous membrane S with

次に、処置具チャンネルに従来の高周波ナイフ１８を挿通して、図７に示すように、病変部Ｘ近傍の粘膜Ｓの一部に当接させ、高周波電流を通電して、全周切開のきっかけとなる孔Ｈを開ける。そして、内視鏡と高周波ナイフとの両方を操作して、病変部Ｘ周囲の粘膜を切開しながら粘膜下層Ｗを露出させる。   Next, a conventional high-frequency knife 18 is inserted into the treatment instrument channel and brought into contact with a part of the mucosa S in the vicinity of the lesion X as shown in FIG. Open a hole H to trigger. Then, by operating both the endoscope and the high-frequency knife, the submucosa W is exposed while incising the mucosa around the lesion X.

次いで、高周波ナイフをチャンネルから抜去するとともに、高周波処置具１をチャンネルに挿入する。そして、一対の腕部３Ａ，３Ｂをチャンネル先端から突出させた状態で、高周波処置具１のスライダ１５を操作部本体１３に対して前進させる。このとき、シース２に対して操作ワイヤ６がシース２の先端方向に前進する。   Next, the high-frequency knife is removed from the channel, and the high-frequency treatment instrument 1 is inserted into the channel. Then, the slider 15 of the high-frequency treatment instrument 1 is moved forward with respect to the operation portion main body 13 with the pair of arm portions 3A and 3B protruding from the channel tip. At this time, the operation wire 6 moves forward in the distal direction of the sheath 2 with respect to the sheath 2.

ここで、処置電極５の先端がシース２の先端近傍に固定されているので、処置電極５が圧縮方向に押され、その反作用として一方の腕部３Ａと他方の腕部３Ｂとが離間して、一対の腕部３Ａ，３Ｂが拡開する。そして、一方の腕部３Ａの挿通孔８Ａに、処置電極５に設けられた折曲部１１が係止されて、一対の腕部３Ａ，３Ｂが所定の開き角度で開いた状態となる。このとき、処置電極５には、シース２の中心軸線Ｃ、即ち、操作ワイヤ６の進退方向に対して略直交した直線部５Ａが形成される。なお、病変部Ｘの大きさに応じて、操作ワイヤ６を進退操作して一対の腕部３Ａ，３Ｂの開き角度を調整してもよい。   Here, since the distal end of the treatment electrode 5 is fixed in the vicinity of the distal end of the sheath 2, the treatment electrode 5 is pushed in the compression direction, and as a reaction, the one arm portion 3A and the other arm portion 3B are separated from each other. The pair of arm portions 3A and 3B expands. And the bending part 11 provided in the treatment electrode 5 is latched by the insertion hole 8A of one arm part 3A, and it will be in the state which opened a pair of arm part 3A, 3B with the predetermined opening angle. At this time, the treatment electrode 5 is formed with a straight portion 5A substantially orthogonal to the central axis C of the sheath 2, that is, the advancing / retreating direction of the operation wire 6. Note that the opening angle of the pair of arm portions 3A and 3B may be adjusted by operating the operation wire 6 forward and backward according to the size of the lesion X.

この直線部５Ａを粘膜下層Ｗに当接させながら高周波電流を流し、内視鏡を固定した状態で観察しながら、高周波処置具１のシース２をチャンネルに対して前進させる。こうして、図８に示すように、直線部５Ａにより粘膜下層Ｗが切開され、病変部Ｘが剥離する。   A high frequency current is applied while the linear portion 5A is in contact with the submucosal layer W, and the sheath 2 of the high frequency treatment instrument 1 is advanced with respect to the channel while observing in a state where the endoscope is fixed. Thus, as shown in FIG. 8, the submucosal layer W is incised by the straight portion 5A, and the lesion X is peeled off.

この高周波処置具１によれば、一対の腕部３Ａ，３Ｂをシース２の先端から突出させて開いたときに、一対の腕部３Ａ，３Ｂの先端側に、シース２の中心軸線Ｃに対して交差する方向に処置電極５を張ることができる。そのため、処置電極５を張った状態で一対の腕部３Ａ，３Ｂをシース２に対して進退操作したときに、従来よりも処置電極５と病変部Ｘ等の対象組織との接触面積を増加させることができる。従って、処置電極５の直接操作により対象組織に対する処置を可能として、手技の容易化を図ることができる。   According to the high-frequency treatment instrument 1, when the pair of arm portions 3A and 3B are opened by protruding from the distal end of the sheath 2, the distal end side of the pair of arm portions 3A and 3B is located with respect to the central axis C of the sheath 2. The treatment electrode 5 can be stretched in the crossing direction. Therefore, when the pair of arms 3A and 3B are advanced and retracted with respect to the sheath 2 with the treatment electrode 5 stretched, the contact area between the treatment electrode 5 and the target tissue such as the lesion X is increased as compared with the conventional case. be able to. Therefore, it is possible to treat the target tissue by direct operation of the treatment electrode 5 and facilitate the procedure.

また、一対の腕部３Ａ，３Ｂを開閉する際に、操作ワイヤ６を介してシース２に対して処置電極５を進退させることにより実施することができ、一対の腕部３Ａ，３Ｂを閉じたときには、処置電極５を一対の腕部３Ａ，３Ｂに収納することができる。   Further, when opening and closing the pair of arm portions 3A and 3B, the treatment electrode 5 can be advanced and retracted with respect to the sheath 2 via the operation wire 6, and the pair of arm portions 3A and 3B are closed. Sometimes, the treatment electrode 5 can be housed in the pair of arms 3A and 3B.

次に、第２の実施形態について図９を参照しながら説明する。
なお、上述した第１の実施形態と同様の構成要素には同一符号を付すとともに説明を省略する。
第２の実施形態と第１の実施形態との異なる点は、本実施形態に係る高周波処置具２０の処置電極２１の一部が、一対の腕部３Ａ，３Ｂが開いたときに屈曲した状態で張られるとした点である。 Next, a second embodiment will be described with reference to FIG.
In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment mentioned above, and description is abbreviate | omitted.
The difference between the second embodiment and the first embodiment is that a part of the treatment electrode 21 of the high-frequency treatment instrument 20 according to this embodiment is bent when the pair of arm portions 3A and 3B are opened. It is a point that it was stretched with.

処置電極２１には、第１の実施形態に係る処置電極５の直線部５Ａに相当する部分に、屈曲部２２が設けられている。屈曲部２２は、処置電極２１が張られた状態で、シース２の先端側に向かうように形成されている。即ち、屈曲部２２を挟んで第一直線部２３Ａ及び第二直線部２３Ｂが形成されることにより、一対の腕部３Ａ，３Ｂに配された状態の部分も含めて、処置電極２１が、略Ｍ字状に張られるようになっている。   The treatment electrode 21 is provided with a bent portion 22 at a portion corresponding to the straight portion 5A of the treatment electrode 5 according to the first embodiment. The bent portion 22 is formed to face the distal end side of the sheath 2 in a state where the treatment electrode 21 is stretched. That is, by forming the first straight portion 23A and the second straight portion 23B across the bent portion 22, the treatment electrode 21 including the portion arranged in the pair of arm portions 3A and 3B is substantially M It is designed to be stretched in a letter shape.

この高周波処置具２０によれば、図示しない対象組織を屈曲部２２に挟むことができ、対象組織と処置電極２１とを安定した状態で接触させることができる。   According to the high-frequency treatment tool 20, a target tissue (not shown) can be sandwiched between the bent portions 22, and the target tissue and the treatment electrode 21 can be brought into stable contact with each other.

次に、第３の実施形態について図１０及び図１１を参照しながら説明する。
なお、上述した他の実施形態と同様の構成要素には同一符号を付すとともに説明を省略する。
第３の実施形態と第１の実施形態との異なる点は、本実施形態に係る高周波処置具３０の一対の腕部３１Ａ，３１Ｂが、コイルシース（シース）３２内に進退自在に配されて、軸心を有する図示しない操作ワイヤの先端に、枢軸３３を有する図示しないリンク機構を介して設けられて軸心に対して開閉可能とされ、処置電極３５が、一対の腕部３１Ａ，３１Ｂの互いの先端側を連結して配され、一対の腕部３１Ａ，３１Ｂが閉じたときに折り畳まれ、かつ、一対の腕部３１Ａ，３１Ｂが開いたときに腕部３１Ａ，３１Ｂ間に張られるとした点である。 Next, a third embodiment will be described with reference to FIGS.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the third embodiment and the first embodiment is that the pair of arm portions 31A, 31B of the high-frequency treatment device 30 according to the present embodiment are arranged in a coil sheath (sheath) 32 so as to freely advance and retract, An operating wire (not shown) having an axial center is provided at a tip of an operating wire (not shown) having a pivot 33 so as to be openable and closable with respect to the axial center, and the treatment electrode 35 is connected to the pair of arm portions 31A and 31B. Are connected to each other, folded when the pair of arms 31A and 31B are closed, and stretched between the arms 31A and 31B when the pair of arms 31A and 31B are opened. Is a point.

この高周波処置具３０の作用について説明する。
図１１（ａ）に示すように、一対の腕部３１Ａ，３１Ｂが閉じられ、処置電極３５が一対の腕部３１Ａ，３１Ｂ間に折り畳まれた状態で図示しない処置具チャンネルから突出させた後、一対の腕部３１Ａ，３１Ｂを開く場合には、図示しない操作ワイヤをコイルシース３２に対して先端側に前進移動させる。 The operation of the high-frequency treatment tool 30 will be described.
As shown in FIG. 11 (a), after the pair of arm portions 31A and 31B are closed and the treatment electrode 35 is folded between the pair of arm portions 31A and 31B, it protrudes from a treatment instrument channel (not shown) When opening the pair of arm portions 31 </ b> A and 31 </ b> B, an operation wire (not shown) is moved forward with respect to the coil sheath 32 toward the distal end side.

このとき、図示しないリンク機構を介して一対の腕部３１Ａ，３１Ｂが操作ワイヤ３２の軸心からそれぞれ離間するようにして開く。この際、図１１（ｂ）に示すように、処置電極３５の両端が一対の腕部３１Ａ，３１Ｂに沿って離間して、処置電極３５が徐々に張られていく。そして、一対の腕部３１Ａ，３１Ｂを所定の開き角度で開いたとき、図１１（ｃ）に示すように、処置電極３５が一対の腕部３１Ａ，３１Ｂ間に張られた状態となる。   At this time, the pair of arm portions 31A and 31B are opened so as to be separated from the axis of the operation wire 32 via a link mechanism (not shown). At this time, as shown in FIG. 11B, both ends of the treatment electrode 35 are separated along the pair of arm portions 31A and 31B, and the treatment electrode 35 is gradually stretched. When the pair of arm portions 31A, 31B are opened at a predetermined opening angle, the treatment electrode 35 is stretched between the pair of arm portions 31A, 31B as shown in FIG.

切開を終了して操作ワイヤをコイルシース３２の基端側に後退させて、一対の腕部３１Ａ，３１Ｂを閉じた際には、図１１（ａ）に示すように、処置電極３５が再び一対の腕部３１Ａ，３１Ｂに挟まれた状態で収納される。
この高周波処置具３０によれば、第１の実施形態と同様の効果を奏することができる。 When the incision is finished and the operation wire is retracted to the proximal end side of the coil sheath 32 and the pair of arm portions 31A and 31B are closed, as shown in FIG. It is stored in a state sandwiched between the arm portions 31A and 31B.
According to the high-frequency treatment instrument 30, the same effects as those of the first embodiment can be obtained.

次に、第４の実施形態について図１２から図１４を参照しながら説明する。
なお、上述した他の実施形態と同様の構成要素には同一符号を付すとともに説明を省略する。
第４の実施形態と第３の実施形態との異なる点は、本実施形態に係る高周波処置具４０の一対の腕部４１Ａ，４１Ｂの先端側が、図１２に示すように、操作ワイヤ４２の軸心からシース２の外径よりも大きく離間するように付勢されているとした点である。 Next, a fourth embodiment will be described with reference to FIGS.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the fourth embodiment and the third embodiment is that the distal end side of the pair of arm portions 41A, 41B of the high-frequency treatment instrument 40 according to the present embodiment is the axis of the operation wire 42 as shown in FIG. The point is that it is biased so as to be separated from the core by a larger distance than the outer diameter of the sheath 2.

一対の腕部４１Ａ，４１Ｂは、板状に形成されており、操作ワイヤ４２の先端に直接基端が、例えば、ろう付けやレーザ溶接によって固定接続されている。一対の腕部４１Ａ，４１Ｂは、基端側から先端側に向かってシース２の径方向外方に漸次大きく湾曲されている。   The pair of arm portions 41A, 41B is formed in a plate shape, and the base end is directly connected to the distal end of the operation wire 42 by, for example, brazing or laser welding. The pair of arm portions 41 </ b> A and 41 </ b> B are gradually curved greatly outward in the radial direction of the sheath 2 from the proximal end side toward the distal end side.

次に、本実施形態に係る高周波処置具４０の作用について説明する。
まず、図１３（ａ）に示すように、シース２内に一対の腕部４１Ａ，４１Ｂが閉じられて収納された状態では、処置電極３５は折り畳まれてシース２内に収納された状態となっている。 Next, the effect | action of the high frequency treatment tool 40 which concerns on this embodiment is demonstrated.
First, as shown in FIG. 13A, when the pair of arm portions 41 </ b> A and 41 </ b> B are closed and stored in the sheath 2, the treatment electrode 35 is folded and stored in the sheath 2. ing.

一対の腕部４１Ａ，４１Ｂを開く場合には、操作ワイヤ４２をシース２に対して先端側に前進移動させる。このとき、図１３（ｂ）に示すように、一対の腕部４１Ａ，４１Ｂの先端側が、シース２から突出するのに伴い、シース２による規制が解除されて一対の腕部４１Ａ，４１Ｂの先端側が拡開し始める。そして、処置電極３５の両端が反対方向に引かれて、処置電極３５が徐々に張られていく。   When opening the pair of arm portions 41 </ b> A and 41 </ b> B, the operation wire 42 is moved forward with respect to the sheath 2 toward the distal end side. At this time, as shown in FIG. 13B, as the distal ends of the pair of arm portions 41A and 41B protrude from the sheath 2, the restriction by the sheath 2 is released, and the distal ends of the pair of arm portions 41A and 41B. The side begins to expand. Then, both ends of the treatment electrode 35 are pulled in opposite directions, and the treatment electrode 35 is gradually stretched.

一対の腕部４１Ａ，４１Ｂ全体がシース２先端から突出した際、図１３（ｃ）に示すように、一対の腕部４１Ａ，４１Ｂが所定の開き角度で開いた状態となり、合わせて処置電極３５が一対の腕部４１Ａ，４１Ｂ間に張られた状態となる。なお、処置電極３５の張り具合によっては、図１４（ａ）に示すように、処置電極３５が一対の腕部４１Ａ，４１Ｂよりも先端側で折り畳まれてシース２に収納される場合もある。この場合には、図１４（ｂ）に示すように、処置電極３５は、一対の腕部４１Ａ，４１Ｂの先端側から基端側に向かって張られていく。   When the entire pair of arm portions 41A and 41B protrude from the distal end of the sheath 2, as shown in FIG. 13C, the pair of arm portions 41A and 41B are opened at a predetermined opening angle. Is stretched between the pair of arm portions 41A and 41B. Depending on how the treatment electrode 35 is tensioned, as shown in FIG. 14A, the treatment electrode 35 may be folded on the tip side of the pair of arm portions 41A and 41B and stored in the sheath 2. In this case, as shown in FIG. 14B, the treatment electrode 35 is stretched from the distal end side to the proximal end side of the pair of arm portions 41A and 41B.

この高周波処置具４０によれば、一対の腕部４１Ａ，４１Ｂとともに処置電極３５をシース２内に収納することができる。   According to the high-frequency treatment instrument 40, the treatment electrode 35 can be housed in the sheath 2 together with the pair of arm portions 41A and 41B.

次に、第５の実施形態について図１５を参照しながら説明する。
なお、上述した他の実施形態と同様の構成要素には同一符号を付すとともに説明を省略する。
第５の実施形態と第４の実施形態との異なる点は、本実施形態に係る高周波処置具５０の操作ワイヤ５１の先端に、一対の腕部５２Ａ，５２Ｂが挿通可能な短管部５３が接続されて、シース５５の外側に沿って配されているとした点である。 Next, a fifth embodiment will be described with reference to FIG.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the fifth embodiment and the fourth embodiment is that a short tube portion 53 into which a pair of arm portions 52A and 52B can be inserted is provided at the distal end of the operation wire 51 of the high-frequency treatment instrument 50 according to this embodiment. It is connected and arranged along the outside of the sheath 55.

短管部５３は、シース５５と略同一の外径を有している。短管部５３は、一対の腕部５２Ａ，５２Ｂの先端からシース５５との接続部位まで移動させた際に、一対の腕部５２Ａ，５２Ｂが所定の開き角度で拡開するように長さが調節されている。   The short tube portion 53 has substantially the same outer diameter as the sheath 55. The short tube portion 53 has a length such that when the pair of arm portions 52A and 52B is moved from the tip of the pair of arm portions 52A and 52B to the connection portion with the sheath 55, the pair of arm portions 52A and 52B expands at a predetermined opening angle. It has been adjusted.

一対の腕部５２Ａ，５２Ｂの先端は、短管部５３の脱落を規制するために外側に折り曲げられている。一対の腕部５２Ａ，５２Ｂの基端は、シース５５の先端に設けられた接続部５５Ａに接続されている。   The tips of the pair of arm portions 52A and 52B are bent outward to restrict the short tube portion 53 from dropping off. The proximal ends of the pair of arm portions 52 </ b> A and 52 </ b> B are connected to a connection portion 55 </ b> A provided at the distal end of the sheath 55.

次に、本実施形態に係る高周波処置具５０の作用について説明する。
まず、図１５（ａ）に示すように、短管部５３が一対の腕部５２Ａ，５２Ｂの先端に移動して配された状態では、処置電極３５が一対の腕部５２Ａ，５２Ｂ間に折り畳まれた状態となっている。 Next, the effect | action of the high frequency treatment tool 50 which concerns on this embodiment is demonstrated.
First, as shown in FIG. 15A, the treatment electrode 35 is folded between the pair of arm portions 52A and 52B in a state where the short tube portion 53 is moved to the tip of the pair of arm portions 52A and 52B. It is in the state.

一対の腕部５２Ａ，５２Ｂを開く場合には、操作ワイヤ５１をシース５５に対して基端側に後退移動させる。このとき、一対の腕部５２Ａ，５２Ｂに対して短管部５３が移動し、図１５（ｂ）に示すように、一対の腕部５２Ａ，５２Ｂの先端側が、短管部５３から突出した状態となり、短管部５３による規制が解除されて一対の腕部５２Ａ，５２Ｂの先端側が拡開し始める。そして、処置電極３５の両端が反対方向に引かれて、処置電極３５が徐々に張られていく。   When opening the pair of arm portions 52 </ b> A and 52 </ b> B, the operation wire 51 is moved backward with respect to the sheath 55 toward the proximal end side. At this time, the short tube portion 53 moves with respect to the pair of arm portions 52A and 52B, and the distal ends of the pair of arm portions 52A and 52B protrude from the short tube portion 53 as shown in FIG. Thus, the restriction by the short pipe portion 53 is released, and the distal ends of the pair of arm portions 52A and 52B begin to expand. Then, both ends of the treatment electrode 35 are pulled in opposite directions, and the treatment electrode 35 is gradually stretched.

この高周波処置具５０によれば、第４の実施形態と同様に、操作ワイヤ５１のシース５５に対する進退操作によって、同様の効果を奏することができる。   According to the high-frequency treatment instrument 50, similar to the fourth embodiment, the same effect can be obtained by the advance / retreat operation of the operation wire 51 with respect to the sheath 55.

次に、第６の実施形態について図１６から図１９を参照しながら説明する。
なお、上述した他の実施形態と同様の構成要素には同一符号を付すとともに説明を省略する。
第６の実施形態と第１の実施形態との異なる点は、本実施形態に係る高周波処置具６０には、第１の実施形態のように一対の腕部３Ａ，３Ｂを有しておらず、図１６に示すように、操作ワイヤ６１が、シース６２に沿って配された第一線状部６１Ａと、第一線状部６１Ａの先端に形成された第一折り曲げ部６１Ｂと、第一折り曲げ部６１Ｂから延びる第二線状部６１Ｃと、第二線状部６１Ｃの途中に形成された第二折り曲げ部６１Ｄとを備えているとした点である。 Next, a sixth embodiment will be described with reference to FIGS. 16 to 19.
In addition, the same code | symbol is attached | subjected to the component similar to other embodiment mentioned above, and description is abbreviate | omitted.
The difference between the sixth embodiment and the first embodiment is that the high-frequency treatment device 60 according to this embodiment does not have a pair of arm portions 3A and 3B as in the first embodiment. 16, the operation wire 61 includes a first linear portion 61A disposed along the sheath 62, a first bent portion 61B formed at the tip of the first linear portion 61A, and a first The second linear portion 61C extending from the bent portion 61B and the second bent portion 61D formed in the middle of the second linear portion 61C are provided.

操作ワイヤ６１は、通常は、第二折り曲げ部６１Ｄにて折り返された状態でシース６２内に収納されており、第二線状部６１Ｃの先端が第一線状部６１Ａの途中まで延びて配されている。そして、第一線状部６１Ａ及び第二線状部６１Ｃをシース６２の先端方向に前進させて、第一折り曲げ部６１Ｂ及び第二折り曲げ部６１Ｄをシース６２から突出させたときに、第一折り曲げ部６１Ｂと第二折り曲げ部６１Ｄとの間に、シース６２の中心軸線Ｃに対して略直交する方向に交差する処置電極６３が形成される。   The operation wire 61 is normally housed in the sheath 62 in a state of being folded at the second bent portion 61D, and the tip of the second linear portion 61C extends to the middle of the first linear portion 61A. Has been. When the first linear portion 61A and the second linear portion 61C are advanced in the distal direction of the sheath 62 and the first bent portion 61B and the second bent portion 61D are protruded from the sheath 62, the first bent portion Between the part 61B and the second bent part 61D, a treatment electrode 63 is formed that intersects in a direction substantially orthogonal to the central axis C of the sheath 62.

第一線状部６１Ａの途中及び第二線状部６１Ｃの先端には、第一線状部６１Ａ及び第二線状部６１Ｃのシース６２先端からの突出量を規制する管状の拡径部（規制部）６５を挟む押さえ部材６６Ａ，６６Ｂが設けられている。押さえ部材６６Ａ，６６Ｂの外径は、拡径部６５の内径よりも大きい径となっている。   In the middle of the first linear portion 61A and the distal end of the second linear portion 61C, a tubular diameter-enlarged portion that restricts the amount of protrusion of the first linear portion 61A and the second linear portion 61C from the distal end of the sheath 62 ( Holding members 66A and 66B that sandwich the restriction portion 65 are provided. The outer diameters of the pressing members 66 </ b> A and 66 </ b> B are larger than the inner diameter of the enlarged diameter portion 65.

シース６２は、外側シース６２Ａと、外側シース６２Ａの内側に嵌合される内側シース６２Ｂとを備えている。内側シース６２Ｂの途中には、押さえ部材６６Ａ，６６Ｂは挿通可能とされる一方、拡径部６５のシース６２の先端側への移動を規制する狭管部６７が設けられている。内側シース６２Ｂの先端には、先端が曲面状のカバー６８が配されている。外側シース６２Ａの先端には、口金６９が設けられている。   The sheath 62 includes an outer sheath 62A and an inner sheath 62B fitted inside the outer sheath 62A. In the middle of the inner sheath 62B, the pressing members 66A and 66B can be inserted, while a narrow tube portion 67 that restricts the movement of the enlarged diameter portion 65 toward the distal end side of the sheath 62 is provided. A cover 68 having a curved tip is disposed at the tip of the inner sheath 62B. A base 69 is provided at the tip of the outer sheath 62A.

操作部７０は、図１９に示すように、先端がシース６２の基端と接続された棒状の操作部本体７１と、操作ワイヤ６１の基端が接続されたスライダ７２とを備えている。スライダ７２は、操作部本体７１に対してスライド自在に嵌合され、かつ、外側シース６２Ａに対して、内側シース６２Ｂ及び操作ワイヤ６１が回転可能となるように接続されている。スライダ７２には、電極端子１６が配されている。   As shown in FIG. 19, the operation unit 70 includes a rod-shaped operation unit main body 71 having a distal end connected to the proximal end of the sheath 62, and a slider 72 to which the proximal end of the operation wire 61 is connected. The slider 72 is slidably fitted to the operation portion main body 71, and is connected to the outer sheath 62A so that the inner sheath 62B and the operation wire 61 can rotate. The electrode terminal 16 is disposed on the slider 72.

次に、本実施形態に係る高周波処置具６０の作用について説明する。
処置電極６３を形成させる場合、図１７に示すように、操作ワイヤ６１全体がシース６２内に収納された状態で図示しない処置具チャンネルから先端側を突出させた後、スライダ７２を操作部本体７１に対して押し出し、操作ワイヤ６１をシース６２に対して前進させる。このとき、図１６（ａ）に示すように、第一線状部６１Ａ及び第二線状部６１Ｃがともにシース６２先端側に移動する。 Next, the effect | action of the high frequency treatment tool 60 which concerns on this embodiment is demonstrated.
When forming the treatment electrode 63, as shown in FIG. 17, the distal end side protrudes from a treatment instrument channel (not shown) in a state where the entire operation wire 61 is accommodated in the sheath 62, and then the slider 72 is moved to the operation portion main body 71. The operation wire 61 is advanced with respect to the sheath 62. At this time, as shown in FIG. 16A, both the first linear portion 61A and the second linear portion 61C move to the distal end side of the sheath 62.

図１８に示すように、第二折り曲げ部６１Ｄがシース６２先端から所定の長さで突出したとき、拡径部６５が狭管部６７と当接する。これにより、第二線状部６１Ｃはシース６２に対して固定状態となる。一方、押さえ部材６６Ａは狭管部６７を通過する。このため、第一折り曲げ部６１Ｂがシース６２から突出したときから、第一折り曲げ部６１Ｂがより折り曲げられ、かつ、第二折り曲げ部６１Ｄを回転中心として、第一折り曲げ部６１Ｂと第二折り曲げ部６１Ｄとの間の第二線状部６１Ｃがシース６２の中心軸線Ｃに対して略直交する方向に回転する。   As shown in FIG. 18, when the second bent portion 61 </ b> D protrudes from the distal end of the sheath 62 with a predetermined length, the enlarged diameter portion 65 comes into contact with the narrow tube portion 67. As a result, the second linear portion 61C is fixed to the sheath 62. On the other hand, the pressing member 66 </ b> A passes through the narrow tube portion 67. Therefore, when the first bent portion 61B protrudes from the sheath 62, the first bent portion 61B is further bent, and the first bent portion 61B and the second bent portion 61D are centered on the second bent portion 61D. The second linear portion 61 </ b> C between and the center of the sheath 62 rotates in a direction substantially perpendicular to the central axis C of the sheath 62.

こうして、図１９に示すように、第一折り曲げ部６１Ｂと第二折り曲げ部６１Ｄとの間に、処置電極６３が形成される。切開する角度を変えるときには、操作部７０を外側シース６２Ａに対して回転させて、処置電極６３の向きを図示しない病変部に対して変更する。
この高周波処置具６０によれば、第１の実施形態と同様の効果を奏することができる。また、図１８に示すように、拡径部６５と狭管部６７とが接触した状態では、第一線状部６１Ａ及び第二線状部６１Ｃがシース６２と略平行状態のままとなり、第二折り曲げ部６１Ｄを先端としてシース６２から一方向に延びている。従って、処置電極６３に高周波電流を通電させることにより、従来の高周波ナイフと同じ作用・効果を奏することができる。 Thus, as shown in FIG. 19, the treatment electrode 63 is formed between the first bent portion 61B and the second bent portion 61D. When changing the angle of incision, the operation unit 70 is rotated with respect to the outer sheath 62A, and the direction of the treatment electrode 63 is changed with respect to a lesion part (not shown).
According to the high-frequency treatment instrument 60, the same effects as those of the first embodiment can be obtained. As shown in FIG. 18, in a state where the enlarged diameter portion 65 and the narrow tube portion 67 are in contact with each other, the first linear portion 61A and the second linear portion 61C remain substantially parallel to the sheath 62. It extends in one direction from the sheath 62 with the double-folded portion 61D as a tip. Therefore, by applying a high-frequency current to the treatment electrode 63, the same operation and effect as the conventional high-frequency knife can be achieved.

なお、本発明の技術範囲は上記実施の形態に限定されるものではなく、本発明の趣旨を逸脱しない範囲において種々の変更を加えることが可能である。
例えば、上記第１の実施形態では、一方の腕部３Ａのみならず、他方の腕部３Ｂも管状に形成されているとしているが、他方の腕部は管状ではなくても構わず、処置電極の一端が他方の腕部に固定されていればよい。 The technical scope of the present invention is not limited to the above embodiment, and various modifications can be made without departing from the spirit of the present invention.
For example, in the first embodiment, not only one arm portion 3A but the other arm portion 3B is formed in a tubular shape, but the other arm portion may not be formed in a tubular shape. It is sufficient that one end of is fixed to the other arm.

また、一対の腕部の先端形状は、図１に示すように、先端がカットされて面取りされているだけでなく、図２０に示すように、一対の腕部７５Ａ，７５Ｂが閉じた状態で一つの円曲面を形成するように面取りされていてもよく、図２１に示すように、一対の腕部７６Ａ，７６Ｂのそれぞれの先端が、円曲面となるように面取りされていても構わない。   Further, the tip shape of the pair of arm portions is not only chamfered by chamfering the tip as shown in FIG. 1, but also with the pair of arm portions 75A and 75B closed as shown in FIG. It may be chamfered so as to form one circular curved surface, and as shown in FIG. 21, the tip of each of the pair of arm portions 76A, 76B may be chamfered so as to be a circular curved surface.

本発明の第１の実施形態に係る高周波処置具を示す要部断面図である。It is principal part sectional drawing which shows the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 図１の（ａ）Ａ−Ａ断面図、（ｂ）Ｂ−Ｂ断面図である。It is (a) AA sectional drawing of FIG. 1, (b) It is BB sectional drawing. 本発明の第１の実施形態に係る高周波処置具を示す要部断面図である。It is principal part sectional drawing which shows the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の操作部を示す断面図である。It is sectional drawing which shows the operation part of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の使用例を示す説明図である。It is explanatory drawing which shows the usage example of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の使用例を示す説明図である。It is explanatory drawing which shows the usage example of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の使用例を示す説明図である。It is explanatory drawing which shows the usage example of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の使用例を示す説明図である。It is explanatory drawing which shows the usage example of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第２の実施形態に係る高周波処置具を示す要部断面図である。It is principal part sectional drawing which shows the high frequency treatment tool which concerns on the 2nd Embodiment of this invention. 本発明の第３の実施形態に係る高周波処置具を示す要部平面図である。It is a principal part top view which shows the high frequency treatment tool which concerns on the 3rd Embodiment of this invention. 本発明の第３の実施形態に係る高周波処置具の（ａ）閉じた状態、（ｂ）開閉途中の状態、（ｃ）開いた状態を示す要部一部断面平面図である。It is a principal part partial cross section top view which shows (a) the closed state of the high frequency treatment tool concerning the 3rd Embodiment of this invention, (b) the state in the middle of opening and closing, and (c) the opened state. 本発明の第４の実施形態に係る高周波処置具の開いた状態示す（ａ）要部一部断面平面図、（ｂ）要部一部断面側面図である。It is the (a) principal part partial cross section top view which shows the open state of the high frequency treatment tool which concerns on the 4th Embodiment of this invention, (b) The principal part partial cross section side view. 本発明の第４の実施形態に係る高周波処置具の（ａ）閉じた状態を示す要部一部断面平面図、（ｂ）開閉途中の状態示す要部一部断面平面図、（ｃ）開いた状態を示す一部断面要部平面図である。(A) principal part partial cross section top view which shows the closed state of the high frequency treatment tool which concerns on the 4th Embodiment of this invention, (b) principal part partial cross section top view which shows the state in the middle of opening and closing, (c) open It is a partial cross section principal part top view which shows the state. 本発明の第４の実施形態に係る高周波処置具の（ａ）閉じた状態を示す要部一部断面平面図、（ｂ）開閉途中の状態示す要部一部断面平面図である。(A) The principal part partial cross section top view which shows the closed state of the high frequency treatment tool which concerns on the 4th Embodiment of this invention, (b) The principal part partial cross section top view which shows the state in the middle of opening and closing. 本発明の第５の実施形態に係る高周波処置具の（ａ）閉じた状態を示す要部一部断面平面図、（ｂ）開いた状態を示す一部断面要部平面図である。(A) The principal part partial cross section top view which shows the closed state of the high frequency treatment tool which concerns on the 5th Embodiment of this invention, (b) The partial cross section principal part top view which shows the open state. 本発明の第６の実施形態に係る高周波処置具を示す（ａ）要部断面図、（ｂ）（ａ）のＤ−Ｄ断面図である。It is (a) principal part sectional drawing which shows the high frequency treatment tool which concerns on the 6th Embodiment of this invention, (b) It is DD sectional drawing of (a). 本発明の第６の実施形態に係る高周波処置具の閉じた状態を示す要部断面図である。It is principal part sectional drawing which shows the closed state of the high frequency treatment tool which concerns on the 6th Embodiment of this invention. 本発明の第６の実施形態に係る高周波処置具の開閉途中の状態を示す要部断面図である。It is principal part sectional drawing which shows the state in the middle of opening and closing of the high frequency treatment tool which concerns on the 6th Embodiment of this invention. 本発明の第６の実施形態に係る高周波処置具の開いた状態を示す要部断面図である。It is principal part sectional drawing which shows the open state of the high frequency treatment tool which concerns on the 6th Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の変形例を示す要部拡大断面図である。It is a principal part expanded sectional view which shows the modification of the high frequency treatment tool which concerns on the 1st Embodiment of this invention. 本発明の第１の実施形態に係る高周波処置具の変形例を示す要部拡大断面図である。It is a principal part expanded sectional view which shows the modification of the high frequency treatment tool which concerns on the 1st Embodiment of this invention.

符号の説明Explanation of symbols

１，３０，４０，５０，６０ 高周波処置具
２，５５，６２ シース
３Ａ，３Ｂ，３１Ａ，３１Ｂ，４１Ａ，４１Ｂ，５２Ａ，５２Ｂ，７５Ａ，７５Ｂ，７６Ａ，７６Ｂ 腕部
５，３５，６３ 処置電極
６，４２，５１，６１ 操作ワイヤ（細長延長部材）
３２ コイルシース（シース）
６１Ａ 第一線状部
６１Ｂ 第一折り曲げ部
６１Ｃ 第二線状部
６１Ｄ 第二折り曲げ部
６５ 拡径部（規制部）
1, 30, 40, 50, 60 High-frequency treatment instrument 2, 55, 62 Sheath 3A, 3B, 31A, 31B, 41A, 41B, 52A, 52B, 75A, 75B, 76A, 76B Arm portion 5, 35, 63 Treatment electrode 6, 42, 51, 61 Operation wire (elongated extension member)
32 Coil sheath (sheath)
61A 1st linear part 61B 1st bending part 61C 2nd linear part 61D 2nd bending part 65 Expanded diameter part (regulation part)

Claims (1)

シースと、
該シース内に進退自在に配され、
前記シースに沿って配された第一線状部、
該第一線状部の先端に形成された第一折り曲げ部、
該第一折り曲げ部から延びる第二線状部、
及び、該第二線状部の途中に形成された第二折り曲げ部、を有する細長延長部材と、
を備え、
前記第一線状部及び前記第二線状部を前記シースの先端方向に前進させて、前記第一折り曲げ部及び前記第二折り曲げ部を前記シースから突出させたときに、前記第一折り曲げ部と前記第二折り曲げ部との間に、前記シースの中心軸線に対して交差する処置電極が形成され、
前記第一折り曲げ部を前記シース内に位置させつつ前記第二折り曲げ部を前記シースから突出させたときに、前記シースから突出した前記細長延長部材全体が、前記シースと平行に延びる処置電極となり、
前記第一線状部及び前記第二線状部のシース先端からの突出量を規制する規制部が、前記第二折り曲げ部よりも基端側の前記第一線状部及び前記第二線状部に設けられていることを特徴とする高周波処置具。 A sheath,
Arranged freely in the sheath,
A first linear portion disposed along the sheath;
A first bent portion formed at the tip of the first linear portion;
A second linear portion extending from the first bent portion;
And the elongate extending member which has the 2nd bending part formed in the middle of the 2nd line part, and
With
The first bent portion when the first bent portion and the second bent portion are advanced in the distal direction of the sheath and the first bent portion and the second bent portion are protruded from the sheath. And a treatment electrode that intersects the central axis of the sheath is formed between the second bent portion and the second bent portion,
When the second bent portion is protruded from the sheath while the first bent portion is positioned in the sheath, the entire elongated extension member protruding from the sheath becomes a treatment electrode extending in parallel with the sheath,
The restricting portion for restricting the protruding amount from the sheath distal end of the first linear portion and the second linear portion is the first linear portion and the second linear shape on the proximal end side with respect to the second bent portion. A high-frequency treatment instrument characterized by being provided in a section.
JP2006156392A 2006-06-05 2006-06-05 High frequency treatment tool Active JP4767761B2 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
JP2006156392A JP4767761B2 (en) 2006-06-05 2006-06-05 High frequency treatment tool
EP14164119.1A EP2756816B1 (en) 2006-06-05 2007-06-05 High-frequency treatment instrument
EP07011059.8A EP1864622B1 (en) 2006-06-05 2007-06-05 High-frequency treatment instrument
US11/810,372 US9033978B2 (en) 2006-06-05 2007-06-05 High-frequency treatment instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP2006156392A JP4767761B2 (en) 2006-06-05 2006-06-05 High frequency treatment tool

Publications (2)

Publication Number Publication Date
JP2007319612A JP2007319612A (en) 2007-12-13
JP4767761B2 true JP4767761B2 (en) 2011-09-07

Family

ID=38462523

Family Applications (1)

Application Number Title Priority Date Filing Date
JP2006156392A Active JP4767761B2 (en) 2006-06-05 2006-06-05 High frequency treatment tool

Country Status (3)

Country Link
US (1) US9033978B2 (en)
EP (2) EP2756816B1 (en)
JP (1) JP4767761B2 (en)

Families Citing this family (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040204705A1 (en) * 2003-04-10 2004-10-14 Scimed Life Systems, Inc. Cryotreatment devices and methods of forming conduction blocks
JP5235709B2 (en) * 2009-02-10 2013-07-10 Ｈｏｙａ株式会社 Endoscopic high-frequency treatment instrument
JP2011212315A (en) * 2010-03-31 2011-10-27 Fujifilm Corp High frequency treatment instrument for endoscope
US20130018384A1 (en) * 2011-07-15 2013-01-17 Gary Kappel Medical Retrieval and Capture Device and Related Methods of Use
EP2929851A1 (en) * 2014-04-08 2015-10-14 Günter Farin Instrument for resection of superficial lesions
US9597105B2 (en) * 2014-04-17 2017-03-21 Covidien Lp Vibrating surgical instruments for blunt dissection
US9603616B2 (en) * 2014-04-17 2017-03-28 Covidien Lp Vibrating surgical instruments for blunt dissection and methods for use thereof
JP6084338B2 (en) * 2014-07-10 2017-02-22 オリンパス株式会社 Endoscopic submucosal dissection device and endoscope system
GB201609019D0 (en) 2016-05-23 2016-07-06 Gyrus Medical Ltd Electrode assembly
JP2023500892A (en) 2019-11-06 2023-01-11 インサイトフル インストゥルメンツ， インコーポレイテッド Systems and methods for dissecting tissue
DE102020124917A1 (en) * 2020-09-24 2022-03-24 Frank Schure Medical instrument for minimally invasive removal of biological material from a human or animal body
WO2023102386A1 (en) * 2021-11-30 2023-06-08 Insightful Instruments, Inc. Systems and methods for incising tissue

Family Cites Families (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2132808C3 (en) * 1971-07-01 1981-10-29 Deyhle, Peter, Dr.med., 8520 Erlangen Device for the diathermic removal of growths
US3955578A (en) * 1974-12-23 1976-05-11 Cook Inc. Rotatable surgical snare
US4181131A (en) 1977-02-28 1980-01-01 Olympus Optical Co., Ltd. High frequency electrosurgical instrument for cutting human body cavity structures
JPS53105888A (en) * 1977-02-28 1978-09-14 Olympus Optical Co Instrument for opening with high frequency wave
GB2011258A (en) * 1977-11-18 1979-07-11 Wolf Gmbh Richard Device for removing excrescences and polyps
DE3419962A1 (en) * 1983-05-30 1984-12-06 Olympus Optical Co., Ltd., Tokio/Tokyo HIGH FREQUENCY INCISION AND EXCISION INSTRUMENT
US4718419A (en) 1985-08-05 1988-01-12 Olympus Optical Co., Ltd. Snare assembly for endoscope
JPS6264355A (en) * 1985-09-17 1987-03-23 オリンパス光学工業株式会社 High frequency inciser
JP3209559B2 (en) * 1992-02-10 2001-09-17 オリンパス光学工業株式会社 Endoscope treatment tool
US5437665A (en) * 1993-10-12 1995-08-01 Munro; Malcolm G. Electrosurgical loop electrode instrument for laparoscopic surgery
JP3655664B2 (en) 1995-05-02 2005-06-02 オリンパス株式会社 High frequency knife
US5769880A (en) 1996-04-12 1998-06-23 Novacept Moisture transport system for contact electrocoagulation
US5961526A (en) 1998-02-18 1999-10-05 Boston Scientific Corporation Coaxial needle and severing snare
US6093185A (en) * 1998-03-05 2000-07-25 Scimed Life Systems, Inc. Expandable PMR device and method
US6221039B1 (en) * 1998-10-26 2001-04-24 Scimed Life Systems, Inc. Multi-function surgical instrument
US6015415A (en) * 1999-03-09 2000-01-18 General Science And Technology Polypectomy snare instrument
US6395001B1 (en) * 2000-04-10 2002-05-28 Health Care Technologies, Llc Electrosurgical electrode for wedge resection
US6929642B2 (en) 2002-06-28 2005-08-16 Ethicon, Inc. RF device for treating the uterus
US20040002702A1 (en) * 2002-06-28 2004-01-01 Ethicon, Inc. RF device for treating the uterus
JP3923022B2 (en) 2003-02-28 2007-05-30 オリンパス株式会社 Endoscopic treatment tool
JP2005348844A (en) * 2004-06-09 2005-12-22 Hiroyuki Kuwano Endoscopic operation appliance
US20060064113A1 (en) * 2004-09-17 2006-03-23 Nakao Naomi L Endoscopic mucosal resection method and associated instrument
US7758593B2 (en) * 2006-05-04 2010-07-20 Ethicon Endo-Surgery, Inc. Medical instrument handle and medical instrument having same

Also Published As

Publication number Publication date
US20070282328A1 (en) 2007-12-06
EP1864622A3 (en) 2008-05-07
US9033978B2 (en) 2015-05-19
EP1864622B1 (en) 2017-10-04
EP1864622A2 (en) 2007-12-12
JP2007319612A (en) 2007-12-13
EP2756816B1 (en) 2020-03-25
EP2756816A1 (en) 2014-07-23

Similar Documents

Publication Publication Date Title
JP4767761B2 (en) High frequency treatment tool
KR101022553B1 (en) Endoscope treatment tool
JP5340722B2 (en) Endoscopic treatment tool
JP3722729B2 (en) Endoscope treatment device
EP3058887B1 (en) Energy treatment instrument
JP2008173369A (en) Treatment tool for endoscope
JP5425149B2 (en) Endoscopic treatment tool
JP2007117405A (en) Treatment device for endoscope
JP2007313314A (en) Lumen stabilizer for endoscopic mucosal resection
JP5290658B2 (en) Endoscopic treatment tool
JP2007325830A (en) Treatment appliance for endoscope and endoscope system
JP4616210B2 (en) High frequency treatment tool
JP2006187446A (en) Endoscopic instrument
JP2011212315A (en) High frequency treatment instrument for endoscope
CN112040894B (en) Medical device
KR20170121499A (en) High-frequency treatment device
US10363087B2 (en) Tissue resection device
JP4772386B2 (en) Submucosal layer peeling treatment tool set and submucosal layer peeling treatment tool system
EP1847231B1 (en) Soft bipolar forceps
JP3342034B2 (en) High frequency treatment tool
JP7250639B2 (en) High-frequency knife device for endoscope
JP3791088B2 (en) Forceps device
JP5235709B2 (en) Endoscopic high-frequency treatment instrument
JP6205524B2 (en) Medical device introduction device
JP4426256B2 (en) Endoscopic high-frequency treatment instrument for endoscope

Legal Events

Date Code Title Description
A621 Written request for application examination

Free format text: JAPANESE INTERMEDIATE CODE: A621

Effective date: 20090424

A977 Report on retrieval

Free format text: JAPANESE INTERMEDIATE CODE: A971007

Effective date: 20100212

A131 Notification of reasons for refusal

Free format text: JAPANESE INTERMEDIATE CODE: A131

Effective date: 20100309

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A523

Effective date: 20100510

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A821

Effective date: 20100511

A131 Notification of reasons for refusal

Free format text: JAPANESE INTERMEDIATE CODE: A131

Effective date: 20101116

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A821

Effective date: 20110117

A131 Notification of reasons for refusal

Free format text: JAPANESE INTERMEDIATE CODE: A131

Effective date: 20110215

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A523

Effective date: 20110418

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A821

Effective date: 20110419

TRDD Decision of grant or rejection written
A01 Written decision to grant a patent or to grant a registration (utility model)

Free format text: JAPANESE INTERMEDIATE CODE: A01

Effective date: 20110517

A61 First payment of annual fees (during grant procedure)

Free format text: JAPANESE INTERMEDIATE CODE: A61

Effective date: 20110615

R150 Certificate of patent or registration of utility model

Free format text: JAPANESE INTERMEDIATE CODE: R150

Ref document number: 4767761

Country of ref document: JP

Free format text: JAPANESE INTERMEDIATE CODE: R150

FPAY Renewal fee payment (event date is renewal date of database)

Free format text: PAYMENT UNTIL: 20140624

Year of fee payment: 3

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

S111 Request for change of ownership or part of ownership

Free format text: JAPANESE INTERMEDIATE CODE: R313115

R350 Written notification of registration of transfer

Free format text: JAPANESE INTERMEDIATE CODE: R350

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

S531 Written request for registration of change of domicile

Free format text: JAPANESE INTERMEDIATE CODE: R313531

R350 Written notification of registration of transfer

Free format text: JAPANESE INTERMEDIATE CODE: R350

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250

R250 Receipt of annual fees

Free format text: JAPANESE INTERMEDIATE CODE: R250